| NPI | 1447308770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11639) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MN 1881) | |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2023-09-25 |